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[The influence of the eye prominence on the EOG potential level (author's transl)].

The influence of globe prominence on the electro-oculogram potential level was measured in patients with unilateral protrusio bulbi, myopia or hyperopia. The EOG potential level on the side with the more prominent globe was lower if the prominence was due to protrusion. If the prominence was due to myopia, the EOG potential was higher compared to the contralateral non-myopic eye. In hyperopic eyes the potential level was lower.

Adaptation, Ocular↗

The Kenny syndrome, a rare type of growth deficiency with tubular stenosis, transient hypoparathyroidism and anomalies of refraction.

One family (3 cases) with the Kenny syndrome and a second family (3 cases) with features of Kenny syndrome but lacking medullary stenosis are reported. The main symptoms in both families are proportionate dwarfism, cortical thickening of tubular bones, variable anomalies of the calvaria, anemia, transient hypoparathyroidism and variable ocular anomalies. The latter include microphthalmia, and moderate-to-severe myopia or hyperopia. In the first family there was medullary stenosis of most tubular bones. In the second family two cases exhibited mild-to-moderate cortical thickening of tubular bones, but absent or mild medullary stenosis. Possible variability of the Kenny syndrome is discussed. Endocrine studies failed to demonstrate any permanent disturbance of parathormone or calcitonin metabolism, or GH deficiency. Pathogenesis remains unclear. Autosomal dominant inheritance seems to be likely.

Adolescent↗

[Objective determination of accommodation in eyes with permanent central scotoma due to amblyopia (author's transl)].

Objective determination of accommodation in 38 children with permanent central scotoma due to amblyopia on one side (with central and eccentric fixation) revealed: 1. The physiological adaptation of refraction for far and near distances did not serve its purpose. 2. There was either no or an irregular response on hyperopia, which was produced by placing concave lenses in front of the eye while fixing a far object, or on myopia produced by placing convex lenses in front of the eye while fixing a near object. 3. On hindering clear vision which could not be compensated by accommodation there was contrary to normal eyes no reactive change of refraction at all or only a poor one. The accommodation behavior in eyes with permanent central scotoma due to amblyopia does not differ from that in eyes with permanent central scotoma due to organic lesions when using the same test methods.

Accommodation, Ocular↗

Electroretinogram responses and refractive errors in patients with a history of retinopathy prematurity.

Ametropias, particularly myopia, and mild retinal dysfunction are found in eyes with a history of retinopathy of prematurity. The retina is an important controller of refractive development. The aims of this study were to find out whether altered measures of retinal function and ametropias are associated and to consider mechanisms by which the retina might control refractive development. Nine infants and children with a history of stage 1, 2 or 3 retinopathy of prematurity and known courses of refractive development were studied. Spherical equivalents at the time of the electroretinogram ranged from +5.50 to -9.00 diopters. Rod photoresponse characteristics were derived from the a-wave, and postreceptoral components were also analyzed with calculation of the sensitivity and saturated amplitude of the b-wave, the sensitivity of oscillatory wavelet OP2, and average amplitudes of OP3 and OP4. In hyperopic and myopic patients alike, the saturated amplitude and gain of the rod cell response were attenuated. In all patients, b-wave sensitivity was low, but in most there was little effect on saturated b-wave amplitude. In patients with courses toward myopia, the amplitude of OP4, an 'OFF' signal, is relatively more attenuated than that of OP3, an 'ON' signal. OP4 is relatively larger in patients with courses toward hyperopia. The OP results suggest that an imbalance of 'ON' and 'OFF' activity in the retina is associated with development of ametropias in retinopathy of prematurity.

Child↗

Ring electrode for radio-frequency heating of the cornea: modelling and in vitro experiments.

Radio-frequency thermokeratoplasty (RF-TKP) is a technique used to reshape the cornea curvature by means of thermal lesions using radio-frequency currents. This curvature change allows refractive disorders such as hyperopia to be corrected. A new electrode with ring geometry is proposed for RF-TKP. It was designed to create a single thermal lesion with a full-circle shape. Finite element models were developed, and the temperature distributions in the cornea were analysed for different ring electrode characteristics. The computer results indicated that the maximum temperature in the cornea was located in the vicinity of the ring electrode outer perimeter, and that the lesions had a semi-torus shape. The results also indicated that the electrode thickness, electrode radius and electrode thermal conductivity had a significant influence on the temperature distributions. In addition, in vitro experiments were performed on rabbit eyes. At 5 W power, the lesions were fully circular. Some lesions showed non-uniform characteristics along their circular path. Lesion depth depended on heating duration (60% of corneal thickness for 20 s, and 30% for 10 s). The results suggest that the critical shrinkage temperature (55-63 degrees C) was reached at the central stroma and along the entire circular path in all the cases.

Animals↗

[Thermal damage to the corneal endothelium in diode laser thermokeratoplasty].

Laser thermokeratoplasty (LTK) can be applied for correction of hyperopia and astigmatism by means of concentrically placed coagulations. Because of the temperature rise during coagulation, damage of the endothelial cells directly below the irradiated areas is possible. In this study, we examined the extent of the thermally denatured zones for different laser parameters and the threshold of thermal endothelial damage as a function of of temperature and duration of elevated temperatures. The threshold for thermal damage of endothelial cells was determined in isotonic NaCl solution for temperature exposures of 10 s and 1 min in a water bath. To determine the damage zones, corneas were irradiated under standardized conditions with a continuously emitting infrared (cw-IR) laser diode at various wave-lengths and different power values and were stained after preparation with trypan blue and alizarine red. The extensions of the damage zones were compared with calculated isotherms. Fifty percent cell damage was found at temperatures of 65 degrees C for heating times of 10 s and at 59 degrees C for 1 min. With thicker corneas, less laser power and higher absorption coefficients, the damage zone was reduced. The damage range determined corresponded to the calculated isotherms of 60 degrees C and 70 degrees C. Regarding clinical LTK, a loss of endothelial cells can be predicted and minimized or totally avoided by choosing the appropriate irradiation parameters.

Animals↗

Presbyopia among normal individuals.

BACKGROUND: To define ocular variables that might affect the need for early use of reading glasses. METHODS: A retrospective, non-randomized clinical trial was conducted at an aero-medical center. The charts of 100 healthy male pilots who suffered from presbyopia were reviewed. All subjects had undergone a complete eye examination every year for 30 years. Ocular parameters measured at the ages of 20, 30, 40, 45, and 50 years were recorded. Individuals were divided into two groups: those who needed reading glasses at the age of 45 years or earlier (group 1) and those who had needed reading glasses after 45 years of age (group 2). RESULTS: Of all the ocular variables examined each year, two differed significantly between the two groups. Refraction at age 20 was 0.1+/- 0.3 D in group 1 and 0.0 +/- 0.3 D in group 2 ( P <0.05). Amplitude of accommodation at age 20 was 9.5 +/- 1.2 D in group 1 and 9.9 +/- 1.0 D in group 2 ( P <0.05). CONCLUSION: Hyperopia and low amplitude of accommodation at the age of 20 might predispose to early development of presbyopia in normal individuals.

Accommodation, Ocular↗

Magnification-corrected indirect biomicroscopy of the optic nerve head.

BACKGROUND: Proper use of the new Super VitreoFundus and SuperPupil XL non-contact slit-lamp lenses for clinical disc biometry requires knowledge of their comparative magnification. METHODS: The optical performance of each fundus lens is described in terms of axial magnification, lens position, and the correction factor p (in degrees per millimeter) using a calibrated Gullstrand-type model eye adjusted for axial ametropia between -12.5 D and +12.6 D. RESULTS: The total change in axial magnification from myopia to hyperopia was -13.3% to +15.6% (Super VitreoFundus lens), and -13.9% to +14.1% (SuperPupil XL lens). When the fundus lens position was altered with respect to the model eye by +/-2 mm under myopic conditions the change in axial magnification was -5.1% to +7.7% (Super VitreoFundus lens), and -6.5% to +9.7% (SuperPupil XL lens). In the hyperopic condition the change was -3.8% to +5.8%, and -4.9% to +7.3%. Both fundus lenses exhibited a linear relationship between p and degree of ametropia of the model eye, while only the Super VitreoFundus lens displayed a constant relationship between p and ametropia of -5 D to +5 D. CONCLUSIONS: Using the fundus lens correction factor (p), the clinician may be able to estimate the dimensions of optic nerve head features with sufficient accuracy to allow clinical decisions to be made in the evaluation of patients with diagnosed or suspected glaucoma.

Fundus Oculi↗

Magnification-corrected photodynamic therapy.

BACKGROUND: To present a method for performing photodynamic therapy (PDT) with a constant predictable light fluence based on actual laser spot magnification. METHODS: A calibrated Gullstrand-type model eye with a scale of half circles in the centre of the artificial fundus was used for this study. The axial length of the model eye was set to different values ranging from 20 to 31 mm, and the actual laser spot magnification of four indirect condensing laser lenses were determined using a PDT laser unit. RESULTS: Equations for determining the actual laser spot magnification were calculated for each laser lens. The total change in laser spot magnification from hyperopia (axial length 20 mm) to myopia (axial length 31 mm) was -20% to +24.8% for Mainster Standard lens (Ocular Instruments Inc, Bellevue, Washington, USA), -15.7% to +27.7% for Mainster Wide Field lens (Ocular Instruments Inc), -16.3% to +33.1% for Volk Transequator lens (Volk Optical Inc, Mentor, Ohio, USA), and -19.2% to +24.4% for Volk PDT Laser lens (Volk Optical Inc). CONCLUSIONS: Axial length of the eye has a considerable effect on PDT laser spot magnification when an indirect laser lens is used. By calculating the actual laser spot magnification in conjunction with knowledge of the true greatest linear dimension of the neovascular lesion, the clinician may be able to deliver a constant predictable amount of light fluence to the fundus independent of the axial length of the PDT treating eye.

Choroidal Neovascularization↗

Prevalence of myopia in an adult population of two different ethnic groups in the Ecuadorian Amazon.

PURPOSE: To determine the prevalence of myopia in the adult populations of two different ethnic communities in the Ecuadorian Amazon. METHODS: Refraction with retinoscopy after cycloplegia was performed for 507 Naporuna (an ethnic group indigenous to the jungles of the Ecuadorian Amazon) and for 776 settlers (white-mestizos from the Andes, now living in the Amazon and working for the petroleum industry). Ages ranged from 18 to 45 years. All subjects had little or no formal education. RESULTS: The prevalence of myopia was 4.7% among the Naporuna and 5.5% among the settlers; the prevalence of hyperopia was higher, at 17.8% and 36.0%, respectively. CONCLUSIONS: The prevalence of myopia in the two communities studied agrees with the results of other studies showing a low prevalence of myopia among groups with low levels of formal education or groups living a nonurban lifestyle.

Adolescent↗

Choroidal folds.

We documented the presence of choroidal folds in a series of 59 eyes. Fifteen separate conditions were established as causes of the choroidal folds. Hyperopia was the most common cuase, although no definite etiology could be established in ten cases.

Adolescent↗

Optical constants and dimensions for the myopic, hyperopic and normal rhesus eye.

Complete optical constants and physical dimensions are presented for eight ametropic rhesus eyes in the range from -11.00 diopters of myopia to +8.00 diopters of hyperopia and compared with the same measurements from 40 essentially emmetropic normal control eyes. The optical constants are calculated from a Gullstrand analysis modified for the rhesus eye, and include focal lengths, cardinal points, lens power and total optical power. The physical dimensions, from keratometry and ultrasound, include corneal radius, anterior chamber depth, lens thickness, vitreous depth and axial length. A regression analysis of the data shows that refraction is strongly correlated with both axial length and vitreous depth (at the rate of 3.7 and 4.2 diopters mm-1, respectively; correlation coefficients of -0.962 and -0.821) but is essentially independent of lens power, corneal power, and total optical power. These results allow us to infer that experimentally induced ametropia in the rhesus is caused by a distortion of the globe, and is not caused by the cornea or the lens.

Animals↗

Correlations between familial refractive error and children's non-cycloplegic refractions.

We examined the spherical equivalent refractions of 237 subjects who had been seen four or more times in a longitudinal study of refractive development in normal children. We employed both photorefraction and autorefraction using a Canon R1 autorefractor. We performed an analysis of variance (F-test for Lack of Fit) to determine the significance of a linear regression in fitting these refractions against three different measures of familial refractive status. One measure included only the number of myopic parents, a second took into account the number of hyperopic parents, and a third included the refractive states of extended genetic relatives. We found no significant correlation between photorefractive data and familial refractions; however, we did find significant, albeit weak, correlations between all measures of familial refractive status and infrared autorefractions of their children. A linear relationship between autorefractive data and overall familial refractive state was found to be most significant. Linear regression of children's autorefractions against a measure of parental myopia and hyperopia was less significant, while a linear model fitting only a measure of parental myopia was least significant, in addition to showing other non-linear trends. We attribute the failure to find a significant correlation between parent and offspring refractions using children's photorefractive data to vignetting by the apparatus and to the short distance of the fixation target. We believe the significant correlation patterns found with the autorefractor reflect the inheritance patterns of parental and familial refractive states.

Adolescent↗

The course of myopia in children with mild retinopathy of prematurity.

The courses of spherical equivalent in patients (n = 62) who had mild, non-cicatricial retinopathy of prematurity (ROP), and in those without a history of ROP (n = 25) were modeled as a linear function of age; an exponential model was also considered. A few (n = 5) without ROP have abnormal courses characterized by hyperopia in early infancy; none have poor acuity. Although the majority of patients with ROP have courses indistinguishable from those of term born controls, 27 (43.5%) have abnormal courses, most of which are toward myopia. Optotype acuities were significantly poorer among the ROP patients with abnormal than normal refractive courses. Thus abnormal refractive development and acuity deficits are associated in eyes that have had mild ROP.

Adolescent↗

Photoperiod, early post-natal eye growth, and visual deprivation.

(1) We studied the influence of photoperiod and unilateral lid suture on post-natal ocular growth in two types of White Leghorn chicks previously reported to respond differently to visual deprivation, Truslow and Cornell K chicks. We analyzed the chicks after 2 weeks of rearing, a time period commonly used in neuropharmacological studies of eye growth but much shorter than in most prior studies of photoperiod effects on the chick eye. (2) Altering the photoperiod length significantly influenced the refraction and growth of both open and sutured eyes even at this early time, with differences between the two types of chicks. (3) The most prominent effect on the open eyes was the development of hyperopia with rearing under constant light, a response especially prominent in the Cornell K chicks. In the open eyes under this condition, the anterior chamber shallowed and the vitreous chamber elongated in the axial dimension only, reciprocal changes that resulted in no net alteration of axial length at 2 weeks. A high variability in refraction of open eyes reared with constant illumination suggests the need for a dark period in the regulation of eye growth. (4) Compared to contralateral open eyes, the lid-sutured eyes of both types of chicks developed longer total axial lengths and enlarged vitreous chambers in both axial and equatorial dimensions under each photoperiod. The effects on anterior chamber depth and refraction were complex and differed between the two types of chicks. (5) The responses in open eyes support the notion that growth of the vitrious chamber of the chick eye is differentially regulated in the axial and equatorial dimensions, previously indicated by pharmacological studies. The responses in both open and sutured eyes indicate different control mechanisms for anterior chamber and vitreous cavity growth.

Animals↗

Effects on the compensatory responses to positive and negative lenses of intermittent lens wear and ciliary nerve section in chicks.

This study examined the ocular compensation to lens-induced defocus in chick and the effect of interrupting lens wear on a daily basis. Eyes fitted with +10 D lenses at hatching compensated rapidly, with almost complete compensation after 4 days of lens wear; they had decreased vitreous chamber depth compared to normal eyes and were thus hyperopic when the lenses were removed. In contrast, adaptation to the -10 D lenses was much slower, was still incomplete after 9 days of lens wear, and in this case, eyes had increased vitreous chamber depth and were myopic without the lenses. Adaptation improved when lens wear was delayed until 7 days after hatching. The effect of interrupting lens wear by periods of normal vision varied with the sign of the lenses worn. Hyperopia was always seen in response to +10 D lenses, although the magnitude of the response decreased as the duration of lens wear was decreased. In contrast, even brief periods of normal vision, i.e., 3 hr, prevented the development of myopia in response to the -10 D lenses; this apparent sensitivity to normal vision is similar to that reported for form-deprivation myopia. Ciliary nerve section used here to eliminate accommodation did not alter these response patterns.

Accommodation, Ocular↗

Consequences of monocular diplopia for the contrast sensitivity function.

Though the human eye generally creates a single image on the retina, the literature contains many examples showing perceptual monocular diplopia. Previously, monocular diplopia resulting from astigmatic defocus has been demonstrated to cause a notch (local minimum) in the contrast sensitivity function (CSF). We examine Verhoeff's (1900) model which explains how monocular diplopia can occur through an interaction between defocus and common ocular aberrations. From the measured ocular transverse aberration function and from the measured monocular diplopia of three cyclopleged subjects we predicted multiple notches in the CSF with hyperopic spherical defocus. Monochromatic and polychromatic CSF were measured for vertical gratings with best refraction and with simulated myopia and hyperopia. Multiple notches in CSF were observed experimentally. Notches in the polychromatic CSF were smaller and broader than those found in the monochromatic CSF. Our aberration model was successful in predicting notches in the CSF with hyperopic spherical defocus. The implications for clinical measurement of CSF are discussed.

Adult↗

Monocular diplopia caused by ocular aberrations and hyperopic defocus.

As a single aperture, approximately monofocal optical system, the human eye generally creates a single image on the retina. However, the literature contains many reports of perceptual monocular diplopia. While it is easy to understand how distortion may produce monocular diplopia, its reported high incidence in normal eyes is less easily understood. We examine a model which ascribes monocular diplopia to an interaction between defocus and ocular spherical aberration. Using a psychophysical hyperacuity-based alignment procedure we measured the transverse aberration function in 0.5 mm steps horizontally across the pupil in the eyes of three cyclopleged subjects. Ocular transverse aberration functions were derived with best refraction and with simulated myopia and hyperopia. Monocular diplopia was also measured under the same conditions. All three subjects showed significant, but different, degrees of positive spherical aberration. The measured ocular transverse aberration functions were predictably modified by the hyperopic and myopic defocus. Hyperopic defocus combined with positive (myopic) spherical aberration changes a monotonic transverse aberration function with a single inflection point into a biphasic function with two inflection points. The locations of the inflections predict the presence and magnitude of the perceived diplopia. These experimental results confirm Verhoeff's (1900) hypothesis for the ocular cause of monocular diplopia.

Adult↗